Fact Sheet
From ReproductiveFacts.org
The Patient Education Website of the American Society for Reproductive Medicine
Optimizing male fertility
What are our chances of getting pregnant?
The chance of a normal heterosexual couple getting
pregnant is 20% to 37% by three months, 75% by six
months, and 90% at one year. Of those couples that do
not get pregnant in the first year, as many as 50% will
get pregnant in the next year. Couples that have tried
to have a baby without success for more than a year, or
less if the female is more than 35 years old, may wish
see a fertility specialist. About 20% of infertility cases
are due to a male factor alone. Another 30% involve
both male and female factors.
How is male fertility evaluated?
The first way a doctor evaluates male fertility involves
a physical exam and medical history. After that,
semen is evaluated. The semen is normally collected
in a sterile container by masturbation. The semen
test gives important information about the amount,
movement, and shape of sperm. If the sperm count is
normal and the sperm are of normal shape and moving
normally, the man is most likely normal. If the results
are abnormal, the man should be evaluated. Because
sperm take over 70 days to produce and mature, illness
or medications within three months of producing the
sample for testing can impair sperm ejaculated on the
day of examination. Hormone blood tests also may be
used to help evaluate male fertility issues.
How often should a couple have intercourse?
Surprisingly, long periods of abstinence can decrease
the quality of sperm. Couples should have intercourse
(sex) at least two to three times a week during the fertile
period. A couple has more chances for pregnancy if
they have intercourse every one to two days during the
fertile window, and a pregnancy is most likely if a couple
has intercourse within the six-day time frame that ends
on the day that an egg is released (ovulation).
Are there coital (sex) practices that can improve
our chances of getting pregnant?
Sperm ejaculated into the vagina reaches the fallopian
tubes within minutes regardless of position during
intercourse. Also, there is no evidence that orgasm or
prolonged rest after intercourse increases the chance
of getting pregnant. Some commercial lubricants and
other substances used for lubrication such as saliva,
olive oil and KY Jelly® should be avoided during the
fertile period. They may make the sperm move slower
and decrease their ability to survive. You may want to
discuss lubricant choices with your doctor since there
are a few lubricants that are believed to be safe for use
when trying to get pregnant.
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Does diet affect fertility?
Obesity has been clearly linked to impaired sperm
production. Overweight men interested in optimizing
fertility should attempt to attain an ideal body weight.
Antioxidants such as vitamins E and C are found
in most multi-vitamins. They may result in a slight
increase in both sperm count and movement. Fruits
and vegetables also provide a natural source of
antioxidants and should be part of a balanced and
healthy diet.
What are the effects of smoking and recreational
drug use?
Smoking is associated with reduced sperm quality.
Men who are trying to get pregnant should consider
stopping smoking immediately. Also, recreational
drugs, including anabolic steroids and marijuana,
are associated with impaired sperm function and
production. They should not be used.
Are boxers shorts or briefs better?
Some studies suggest that wearing brief underwear
may raise the temperature around the scrotum and
cause a decrease in sperm quality. Choosing boxer
underwear is one way to avoid this. The evidence from
these studies is inconclusive. Regardless, avoiding
situations that raise scrotal temperature (like hot tubs
or using laptops on your lap) might improve sperm
quantity and quality.
What else can affect my sperm?
Some medications, chronic medical conditions, and
high fevers can impair the body’s ability to make sperm.
Ask your doctor how your medications or conditions
affect your fertility potential.
How can I improve our chances of getting pregnant?
Like many aspects of our health, a man’s fertility can be
improved by adopting a healthy lifestyle. Maintaining
an ideal weight, a diet rich in antioxidants (found in
fruits and vegetables), as well as multi-vitamins may
improve the quality of sperm. Reducing stress and
controlling chronic medical conditions such as high
blood pressure and diabetes may also improve a man’s
chances of establishing a pregnancy. Remember that
any such changes in the man’s lifestyle will take almost
three months to show an improvement in sperm.
Couples with underlying medical or genetic conditions
should see a doctor so that they can increase their
overall health before getting pregnant.
Revised 2016
For more information on this and other reproductive
health topics, visit www.ReproductiveFacts.org